Reviewing and Redesigning ABI Care Pathways: Learning From Outcomes and Incidents
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Acquired brain injury care pathways cannot remain static. Recovery trajectories change, risks emerge and support models may become misaligned over time. Providers that fail to review and redesign pathways often see repeated incidents, placement drift and declining outcomes. Commissioners and inspectors increasingly expect ABI providers to demonstrate structured pathway review and learning.
This article explores how ABI care pathways can be reviewed and redesigned using outcomes, incidents and governance insight. It should be read alongside Quality Assurance & Auditing and Quality, Safety & Governance.
Why ABI pathways must evolve
ABI is characterised by change. Pathways that once worked may no longer meet need, particularly as cognition, insight or behaviour shift.
Commissioner and inspector expectations
Two expectations are increasingly explicit:
Expectation 1: Evidence-led review. Inspectors expect providers to use outcomes and incidents to inform pathway redesign.
Expectation 2: Governance oversight. Commissioners expect senior oversight of pathway effectiveness.
Using outcomes data to inform redesign
Outcomes data should identify whether pathways are delivering progression, stability or unintended restriction.
Operational example 1: Outcome-triggered redesign
A provider identified stalled progress across several placements and redesigned pathway stages to reintroduce reablement focus.
Learning from incidents and near misses
Incidents provide critical insight into pathway weaknesses, particularly around transitions and risk management.
Operational example 2: Incident trend analysis
A service analysed repeated incidents during transitions and redesigned step-down processes accordingly.
Involving lived experience and frontline insight
Effective redesign incorporates feedback from people using services and frontline staff.
Operational example 3: Co-produced pathway review
A provider involved individuals with ABI in pathway redesign workshops, improving relevance and engagement.
Governance and assurance
Providers should evidence pathway review through:
- Formal pathway review cycles
- Board or senior leadership oversight
- Commissioner reporting on change and impact
Redesign as quality maturity
In ABI services, the ability to redesign pathways is a marker of quality maturity. Providers that learn, adapt and improve demonstrate resilience, accountability and inspection-ready governance.
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